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conferenceseries
.com
Volume 7, Issue 5 (Suppl)
J Palliat Care Med, an open access journal
ISSN: 2165-7386
Geriatrics 2017
September 4-5, 2017
September 4-5, 2017 | Edinburgh, Scotland
Geriatrics Gerontology & Palliative Nursing
7
th
International Conference on
IMPLEMENTATION OF HOME-BASED PRIMARY CARE PROGRAM TO IMPROVE
OUTCOMES OF HOMEBOUND PATIENTS IN A RURAL COMMUNITY: A QUALITY
IMPROVEMENT PROJECT
Christine Collins
a
a
University of Pennsylvania, USA
Statement of the Problem:
The increasing population of older Americans has resulted in an increased need for home based
primary care. This population has a high incidence of multiple chronic health conditions, with an average of eight physical
and mental health conditions and take an average of twelve medications. Due to disabilities, ambulatory dysfunction, and
limited access to transportation, these patients have difficulty leaving the home. The ambulatory outpatient care setting does
not meet the needs of these patients. They turn to the Emergency Department and are more likely to be hospitalized due to a
crisis that may have been prevented by a primary care visit. Care becomes fragmented; health declines, which results in loss of
independence, and can precipitate admission to long term care facilities.
Methodology &Theoretical Orientation:
A nurse practitioner led HBPC practice was created for the rural Tidewater region
of Virginia. The NP project leader (NP-PL) created a referral network for multi-disciplinary services. Patients were enrolled
who met the criteria of being homebound with complex health care problems and visited them at least twice over the four
months of the project. The NP –PL employed a simple survey to evaluate access to care, outcomes and patient satisfaction. The
numbers of primary care assessments were analyzed. ED use and hospitalizations were compared to the history of previous
utilization.
Findings:
15 enrolled in HBPC. The NP-PL visited the participants an average of 5.7 times over the trimester of the project.
Hospitalization and utilization of the Emergency Department rates were lower.
Conclusion & Significance:
Participants received an average of 5.7 visits. 60% (9/15) of participants responded to the survey.
100% of participants responded they experienced improved access to care, improved outcomes, reduced use of ED and
hospitalizations. 100% of participants were satisfied with the care provided by the NP-PL.
Biography
Christine Collins is a Family Nurse Practitioner with over 33 years’ experience. She has extensive experience in Occupational Health with an MSN from the
University of Pennsylvania. She went on to find her passion in Home Based Primary Care (HBPC) and completed her DNP at the University of Massachusetts,
Boston. Her capstone was a quality/practice improvement project developing a rural HBPC in the Tidewater region of Eastern Virginia. She is actively pursuing
expansion of HBPC services to homebound patients.
rivahnurse@gmail.comChristine Collins, J Palliat Care Med 2017, 7:5(Suppl)
DOI: 10.4172/2165-7386-C1-012